Mr Brewin and Mr Johnston specialise in the treatment of urinary tract stones. The most common procedures to treat kidney stones are:
1. Ureteroscopy involves passing a small flexible or semi-rigid scope through the water pipe and bladder up to the ureter and kidney to find the stone. When the stone is visualised using the scope it can then be broken with a laser. The stone can be broken to tiny fragments (the size of grains of sand) which then pass out in the urine, larger fragments can be removed with a tiny basket. Small and medium sized stones (up to 2cm) can be treated with ureteroscopy and laser. Larger stones may need to be treated with a PCNL.
2. Lithotripsy (ESWL) uses where waves to break up the stone. This does not require an anaesthetic; shock waves are passed through the back, and focused on the kidney stone to break them up. A few treatments are usually needed to completely break up the stone and the fragments are passed out in the urine.
Large stones may need to be treated with key hole surgery through the back called a PCNL (per-cutaneous nephrolithotomy). A small incision is made in the back and a needle placed into the kidney. The needle hole is then stretched up to allow a telescope to be passed directly into the kidney. Using this technique larger (over 2cm) stones can be removed from the kidney.
Stents
Depending on the operation and the position and size of the stones some patients may need a temporary ureteric stent inserted either before or after their operation. This is a thin, internal plastic tube that runs from the kidney to the bladder in order to allow the kidney to drain safely. These can cause discomfort and urinary symptoms so these are used for as short a time as possible.
For more information on ureteroscopy, lithotripsy, PCNL and ureteric stents see the BAUS website.